IVF Not Working Again? Know What’s Stopping Pregnancy

ByTarin Hussain
Updated: 13 Aug 2025, 10:08 am
Medical Reviewed by Dr. Shobha Gupta

Recurrent implantation failure (RIF) occurs when good-quality embryos fail to implant after multiple cycles of IVF or other assisted reproductive technologies (ART). Your doctor will use tests to check for issues in the uterus, hormone levels, sperm quality, or embryo genetics. Based on the results, a personalised treatment plan will be created.

Pregatips
Recurrent implantation failure (RIF) can be frustrating and emotionally exhausting. You may feel stuck and unsure of what’s standing in the way of success. But this doesn’t mean your journey is over. There are ways to identify the underlying issues and improve your chances of a successful pregnancy with the right medical support.

In this article:


This stage is about asking the right questions and exploring new options. Fertility specialists can guide you through advanced testing and proper treatment plans to help you move closer to your dream of parenthood.


Recurrent Implantation Failure Diagnosis

To diagnose recurrent implantation failure, doctors first need to understand why implantation isn’t happening. This involves a thorough evaluation of both partners to identify any issues. The main diagnostic tests used are:

  • Hysteroscopy: This procedure involves using a small camera to closely examine the inside of the uterus for abnormalities like fibroids, polyps, or scar tissue that could prevent implantation.
  • Endometrial receptivity analysis (ERA): ERA checks if the uterine lining is ready to accept an embryo at the right time. A biopsy is taken to analyse gene expression, helping doctors pinpoint the best day for embryo transfer.
  • Genetic testing (PGT-A): Preimplantation genetic testing analyses embryos for chromosomal abnormalities before transfer. This makes sure only healthy embryos are used to reduce the risk of failure.
  • Hormonal and blood tests: These tests check hormone levels, thyroid function, and blood clotting issues (like thrombophilia) that might affect implantation. They also look for immune system problems that could reject the embryo.
  • Sperm DNA fragmentation test: This test examines the quality of sperm DNA. Even if a semen analysis looks normal, damaged sperm DNA can lower implantation success rates.
  • Uterine evaluation (hysterosalpingogram): This test checks the uterus and fallopian tubes for blockages, like hydrosalpinx, which can reduce implantation chances by up to 50 per cent.


Treatment Options for Recurrent Implantation Failure

Doctors create a treatment plan once the cause of recurrent implantation failure is identified. These are the main approaches:

  • Improving embryo quality: Advanced lab techniques help select the healthiest embryos for transfer. This increases the chances of successful implantation.
  • Uterine preparation: Hormonal medications, such as progesterone, can prepare the uterine lining for better receptivity. Treating conditions like fibroids, polyps, or chronic endometritis through surgery or medication can also help.
  • Adjusting IVF protocols: Doctors may adjust IVF medications or timing to better suit your body. For example, ERA results can guide the exact day for embryo transfer to match your uterine receptivity window.
  • Blood-thinning medications: If blood clotting issues are found, blood-thinning medications prescribed by your doctor can enhance uterine blood flow and support implantation.
  • Immune system treatments: For immune-related issues, therapies may be used to help the body accept the embryo.




Managing Recurrent Implantation Failure

Managing recurrent implantation failure isn’t only about medical care. It also involves lifestyle changes and emotional support to boost your chances:

  • If you're wondering how to prevent implantation failure, start by focusing on your overall health. Eating a balanced diet with whole grains, keeping a healthy weight, and avoiding alcohol or smoking can improve egg, sperm, and uterine health. Reducing stress through exercise or relaxation techniques is also important.
  • The emotional strain of RIF can be heavy. Counselling, support groups, or therapy can help you process feelings of grief or anxiety.
  • If recurrent implantation failure persists, options like using a surrogate or gestational carrier may be considered. Some people also try alternative therapies like acupuncture along with their treatment. Though more research is needed on their effectiveness.


How Long After Failed Implantation Will Period Start?

Your period usually starts around the same time it would in a normal cycle if implantation fails, which is typically 10 to 14 days after ovulation or egg retrieval in IVF. This timing can vary depending on your individual cycle length and hormonal balance. After a failed implantation, the body stops producing pregnancy-supporting hormones like progesterone. This leads to the shedding of the uterine lining, which triggers your period.

The number of IVF cycles you might need depends on your age, ovarian reserve, and response to treatment. A fertility specialist can help you decide whether to continue with IVF or explore other options. Stay strong, as many people overcome recurrent implantation failure and achieve a healthy pregnancy with the right tests, treatments, and support.


FAQs on IVF Not Working Again? Know What’s Stopping Pregnancy


  1. How is recurrent implantation failure diagnosed?
    Diagnosis involves a thorough evaluation of both partners. Tests may include hysteroscopy, hormonal assessments, sperm DNA fragmentation analysis, genetic testing, and endometrial receptivity analysis (ERA).
  2. What are the treatment options for recurrent implantation failure?
    The treatment plan depends on the cause and may include improving embryo selection, adjusting IVF protocols, using blood thinners, or treating immune-related issues.
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